Currently, there is a substantial lag between the time that services are provided to a patient by a provider, e.g., during an inpatient episode, and the time the provider is paid by a payer. Further there is often a fairly significant difference between an estimated cost for provider services, i.e., estimated accounts receivable (A/R), and what is actually reimbursed to the provider in response to a submitted claim. This lag and pay discrepancy results in accounting headaches and increased administrative expenditures to fix the providers books. Such expenditures are necessarily passed along to patients in the form of increased costs for services. These inaccuracies increase ten-fold when the provider is a hospital or similar network which contracts with multiple other providers (list) and multiple insurance carriers, i.e., payers.
Accordingly, there is a need in the provider environment for the ability to more accurately estimate the A/R. Such a solution would allow the provider to gain an accurate view of A/R.